Individual
MS. TAMARA AUNDREA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
8249 CREEKLINE CT, RIVERDALE, GA 30274-4336
(404) 399-4859
Mailing address
PO BOX 162782, ATLANTA, GA 30321-2782
(404) 399-4859
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010347
GA
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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